Recently,with the factors such as diet and environmental has changed a lot,the incidence of inflammatory bowel disease (IBD) increased year by year,which has attract the attention of the public gradually.There is no simple,noninvasive and relatively specific indicators which could assist the diagnosis,diseases activity evaluation,treatment effect monitoring,and prediction of disease recurrence possibility of IBD,endoscopic examination and histo-pathologic biopsy is the most accurate method used in clinical,but it has the disadvantages of invasive and time consuming which is poorly accepted by patients with IBD.In recent years,with the further research of IBD,a series of noninvasive,convenience and high specificity biomarkers of IBD have been undergone evaluation,especially some fecal biomarkers.

Objective To investige the sensitivity and specificity of anti-proteinase 3 (PR3) capture ELISA in diagnosis of Wegener's granulomatosis (WG),and the correlation between the capture ELISA and indirect immunofluorescence assay (IIF).Methods Anti-PR3 antibody and anti-neutrophil cytoplasmic antibody (cANCA) in sera from 72 patients with WG,206 healthy blood donors and 24 patients with autoimmune diseases were detected by classic ELISA,capture ELISA and IIF.Results The sensitivities of classic ELISA and capture ELISA for detection of anti-PR3 in WG diagnosis were 73.6% and 87.5% respectively.The specificities of both the ELISAs were identical (100%).Detection of anti-PR3 by ELISA or IIF alone led to the serological hit rate of 87.5% and 84.7% for WG respectively,but the combination of capture ELISA and IIF increase the hit rate up to 91.6%.Conclusions The sensitivity of anti-PR3 capture ELISA as well as its correlation with IIF is prior to classic anti-PR3 ELISA.The combined detection of anti-PR3 capture ELISA and IIF may increase the diagnosis rate of clinically suspected WG.

Objective This study was designed to investigate positive rate of serum antibody and the distribution of serotypes of Legionella pneumophila in the patients of author's hospital for recent 5 years.Methods All the inspecting results of antibodies in the 1212 serums by indirect immunofluorescence from Jan 1, 2003 to Oct 31, 2007 were reviewed. The clinical information of patients was collected.Results 163 serums were positive (13.5%). Serotype 4 had the highest positive rate of 12.0% followed by serotype 12 (8.5%), 5 (7.8%), 14 (6.1%), 10 (5.9%). Three simultaneously positive serotypes were dominant (21.0%), and 4 or 5 simultaneously positive serotypes were common. In all departments, the highest positive rate (23.3%) was in respiratory ward, in which serotype 4 and 12 were the most (19.0% and 17.2%, respectively).Conclusions Serotype 4 was the most common type of Legionella pneumophila in serotype 1-14. Cross reaction could exist between Legionella pneumophila and other pathogenic microorganism or in different serotypes.

Objective To investigate the concurrent application value of indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA) in systemic lupus erythematosus (SLE).Methods A retrospective study.All patients who took anti-double stranded DNA (dsDNA) antibody test from June 1 2011 to September 30 2011 in our department were recruited in this study.The patients' anti-dsDNA antibody results and clinical diagnosis were collected and analyzed retrospectively.The consistence,sensitivity and specificity of IIF and ELISA tests were calculated and the consistence was compared by Kappa test.Results The positive rates of detecting anti-dsDNA antibodies by ELISA and IIF tests were 16.3％ and 13.1％ respectively.The consistency between these two tests was 90.8％,and showed good correlation by Kappa test (Kappa =0.641,P ＜ 0.05 ).Of 9.2％ of inconsistent results between IIF andi ELISA,most cases ( 6.2％ ) were ELISA positive and IIF negative.Taking the clinical diagnosis of lupus as a golden standard,the accuracy of IIF and ELISA was 84.8％ and 84.4％ respectively and the difference was no significant (x2 =0.25,P ＞ 0.05 ).The sensitivity and specificity for diagnosing lupus by IIF were 46.1％ and 99.2％,and 51.3％ and 96.7％ by ELISA.Conclusions Our results suggested that anti-dsDNA antibodies in samples should be detected by both ELISA and IIF tests simultaneously.If ELISA was used first and the positive samples were further tested by IIF,at least 3％ of ELISA negative and IIF positive samples would be misdiagnosed as anti-dsDNA antibodies negative.IIF negative and ELISA positive samples should be further analyzed the affinity of anti-dsDNA antibodies in order to help the diagnosis and evaluation of SLE.

Objectives To evaluate the value of Treponema pallidum (TP) antibody analytical methods for syphilis screening.Methods A total of 4870 samples of Peking University First Hospital from May to October 2010 were detected of antibodies against TP by chemiluminescent microparticle immunoassay (CMIA),ELISA,rapid plasma reagin test (RPR),Treponema pallidum particle agglutination assay (TPPA) and dot-immunoblotting test (dot-IBT).The positive rates were compared by McNemar test for paired data;Using dot-IBT as gold standard,the sensitivity,specificity and total accordance rate of the other four methods were analyzed.Results In 4870 screening samples,the positive rate of dot-IBT was 2.5％(122/4870).The positive rate of CMIA and RPR was 3.1％(149/4870) and 1.2％(58/4870),respectively.According to McNemar test for paired data,there was significant difference when compared with dot-IBT (P ＜0.01).The positive rate of ELISA and TPPA was 2.4％ (119/4870) and 2.4％ (116/4870),respectively.There was no significant difference when compared with dot-IBT (P ＞ 0.05).When the dot-IBT results for the standard,CMIA has highest sensitivity,96.7％ (118/122),the specificity was 99.6％(4705/4724).The sensitivity and specificity of ELISA was 93.4％ (114/122) and 99.9％ (4720/4724),respectively,TPPA was 91.0％ (111/122) and 99.9％ (4721/4724),respectively,and RPR was 46.7％(57/122) and 100.0％ (4724/4724),respectively.The accordance rate of CMIA,ELISA,TPPA and RPR with the dot-IBT was 99.5％ (4823/4846),99.8％ (4834/4846),99.7％ (4832/4846) and 98.7％(4781/4846).When the TPPA results for the standard,sensitivity of CMIA was 96.6％ (112/116),the specificity was 99.2％ (4717/4754).The sensitivity and specificity of ELISA was 98.3 ％ (114/116) and 99.9％ (4749/4754),respectively,and RPR was 47.4％ (55/116) and 99.9％ (4751/4754),respectively.The accordance rate of CMIA,ELISA and RPR with the dot-IBT was 99.2％ (4829/4870),99.9％ (4863/4870) and 98.7％ (4806/4870).Conclusions Because of the low sensitivity of RPR,it is not fit for screening test.There are high sensitivity and specificity for detection of TP antibody using CMIA and ELISA,so they could be used as a screening test for TP.Due to the complexity of the operating steps,TPPA can be used to further confirm the test.

Objectives In order to provide valuable information for the diagnosis and treatment of allergic diseases,the prevalence and trend changes of common allergens in Beijing were investigated and analyzed.Methods This study was a retrospective data collection study.A total of 11 641 patients with allergen examinations were collected from Peking University First Hospital from 2013 to 2017.The positive rate of each allergen was counted according to age,season and year.The epidemiological characteristics and trends were analyzed.Results In the past five years,20 636 total IgE and 45 620 allergen-specific IgE were collected,and the total positive rate of total IgE was 47.8％ (9 874/20 636).The top three positive rates of inhaled allergens were Dermatophagoides farina (28.1％,509/1 812),Dermatophagoides pteronyssinus (26.8％,503/1 876) and Mugwort (24.7％,240/971).The top three positive rates of food allergen were egg (17.3％,188/10 88),milk (16.7％,186/1 114) and wheat (15.3％,127/829).The positive rate of inhaled allergens (phad as an example) increased year by year.The positive rate of food allergens (fx5 as an example) reached its peak in 2015 (16.3％,511/3 139) and decreased slightly in the last two years (2016:13.0％,571/ 4 396;2017:7.4％,330/4 461).In inhaled allergens,the positive rate of weed pollen increased significantly in autumn.The positive rates of mx2 and dust mites were higher in summer.Food allergen did not change significantly with the seasons.Conclusions This study shown the distribution of allergens in patients with allergic diseases to a certain extent.It provided epidemiological data and clinical evidence for the prevention and treatment of allergic diseases.

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

Objective: To compare T-cell receptor (TCR) β chain complementarity-determining region 3 (CDR3) in the patients with coexistence of HBsAg and HBsAb and other HBV infected patients. Methods: The clonotype and diversity of CDR3 in blood of group cases (positive HBsAg and HBsAb) (n=11), control 1 (negative HBsAg and positive HBsAb) (n=10) and control 2 (positive HBsAg and negative HBsAb) (n=10) were analyzed by high-throughput TCR sequencing with Illumina HiseqX10. Results: In the case group, the overlap rate of 6.28% (0.25%, 13.10%) was detected between any two samples, which was significantly lower than the overlap rate of 10.49% (6.20%，17.30%) seen in control 1 group (P=0.008). In control 2 group, the overlap rate of 2.60% (0.13%，13.69%) was significantly lower than control 1 group (P=0.001). There was no difference between case group and control 2 group. After pairwise comparison between the three groups, the frequency of clonotype TRBV7-2/TRBD1/TRBJ2-1 in case group was higher than that of control 1 group (P=0.029), the frequency of TRBV7-3/TRBD1/TRBJ2-7 in case group was lower than that of control 1 group (P=0.031). The difference of TRBV5-8 was significant in comparing case group with control 1 group (P=0.047). There were 14 clonotypes which had differences between case group and control 2 group in frequency. TRBV28was significant in comparing case group with control 2 group (P=0.028). For diversity, there was no difference among the three groups. Conclusion Clonotype TRBV7-2/TRBD1/TRBJ2-1, TRBV7-3/TRBD1/TRBJ2-7 and TRBV5-8 were associated with coexistence of HBsAg and HBsAb, but the diversity was not associated with TCR β chain CDR3.

Objective:To investigate the clinical efficacy of proximal gastrectomy and total gastrectomy in the treatment of Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective cohort study was conducted. The clinicopathological data of 170 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to Guangdong Provincial People′s Hospital from January 2010 to December 2018 were collected. There were 125 males and 45 females, aged from 30 to 85 years, with a median age of 64 years. Of the 170 patients, 82 cases undergoing proximal gastrectomy were allocated into the proximal gastrectomy group and 88 cases undergoing total gastrectomy were allocated into the total gastrectomy group. Observation indica-tors: (1) surgical and postoperative situations; (2) follow-up and survival; (3) analysis of prognostic factors. Follow-up was conducted using telephone interview and outpatient examination to detect survival of patients up to December 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measure-ment data with skewed distribution were represented as M( Q1, Q3) or M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Kaplan-Meier method was used to draw survival curves, and Log-Rank test was used for survival analysis. COX proportional hazard model was used for univariate and multivariate analyses. Variables with P<0.1 in univariate analysis were included for multivariate analysis. Results:(1) Surgical and postoperative situations. Cases with surgical approach as transthoracic or thoraco-abdominal approach, transabdominal approach, the operation time, cases with volume of intra-operative blood loss ≤100 mL or >100 mL, cases with length of proximal margin ≤1.5 cm or >1.5 cm, cases with radical surgery outcome as R 0, R 1, R 2, the number of lymph nodes harvest, cases with anastomotic leakage, cases with anastomotic stricture, cases with incision infection, cases with pleural infection or effusion, cases with abdominal infection or ascites were 61, 21, (211±18)minutes, 46, 36, 44, 38, 73, 6, 3, 15(9,22), 5, 2, 2, 4, 2 in the proximal gastrectomy group, respec-tively. The above indicators were 12, 76, (263±15)minutes, 27, 61, 45, 43, 82, 4, 2, 23(18,32), 4, 1, 3, 1, 4 in the total gastrectomy group, respectively. There were significant differences in the surgical approach, operation time, volume of intraoperative blood loss and the number of lymph nodes harvest between the two groups ( χ2=63.94, t=-25.50, χ2=11.19, Z=-5.62, P<0.05). There was no significant difference in the length of proximal margin or radical surgery outcome between the two groups ( χ2=0.11, Z=-0.95, P>0.05) and there was no significant difference in the anastomotic leakage, anastomotic stricture, incision infection, pleural infection or effusion, abdominal infection or ascites between the two groups ( P>0.05). (2) Follow-up and survival. All the 170 patients were followed up for 89(64,106)months. Of the 170 patients, the 5-year overall survival rates were 43.8% and 35.5% of the Siewert type Ⅱ and Ⅲ AEG patients, respectively, showing no significant difference between them ( χ2=0.87, P>0.05). Of the patients with Siewert type Ⅱ AEG, the 5-year overall survival rates were 41.7% and 54.3% in the patients with proximal gastrectomy and the total gastrectomy, respectively, showing no significant difference between them ( χ2=1.05, P>0.05). Of the patients with Siewert type Ⅲ AEG, the 5-year overall survival rates were 31.3% and 37.5% in the patients with proximal gastrectomy and the total gastrectomy, respectively, showing no significant difference between them ( χ2=0.33, P>0.05). The 5-year overall survival rates were 39.0% and 44.2% in the proximal gastrectomy group and the total gastrectomy group, respectively, showing no significant difference between the two groups ( χ2=0.63, P>0.05). Of the patients in TNM stage Ⅰ, stage Ⅱ, stage Ⅲ, the 5-year overall survival rates were 65.3%, 36.3%, 27.1% in the proximal gastrectomy group, versus 83.3%, 48.0%, 39.7% in the total gastrectomy group, showing no signifi-cant difference between the two groups ( χ2=0.02, 1.50, 1.21, P>0.05). (3) Analysis of prognostic factors. Results of univariate analysis showed that pathological N staging, degree of tumor differen-tiation and radical surgery outcome were related factors influencing prognosis of AEG patients ( hazard ratio=1.71, 1.70, 2.85, 95% confidence interval as 1.16-2.60, 1.15-2.50, 1.58-5.14, P<0.05). Results of multivariate analysis showed that pathological N staging and radical surgery outcome were independent factors influencing prognosis of AEG patients ( hazard ratio=1.55, 2.18, 95% confidence interval as 1.05-2.31, 1.18-4.02, P<0.05). Conclusions:There is no significant difference in the prognosis of Siewert type Ⅱ and Ⅲ AEG patients undergoing proximal gastrectomy or total gastrectomy. Proximal gastrectomy can be used for the treatment of advanced Siewert type Ⅱ and Ⅲ AEG.